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The gut microbiome influences the bioavailability of olanzapine in rats
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2021-03-11
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Sofia Cussotto, Jacinta Walsh, Anna V. Golubeva, Alexander V. Zhdanov, Conall R. Strain, Fiona Fouhy, Catherine Stanton, Timothy G. Dinan, Niall P. Hyland, Gerard Clarke, John F. Cryan, Brendan T. Griffin, The gut microbiome influences the bioavailability of olanzapine in rats, EBioMedicine, Volume 66, 2021, 103307, Available at: https://doi.org/10.1016/j.ebiom.2021.103307.
Abstract
Background: The role of the gut microbiome in the biotransformation of drugs has recently come under scrutiny.
It remains unclear whether the gut microbiome directly influences the extent of drug absorbed after
oral administration and thus potentially alters clinical pharmacokinetics.
Methods: In this study, we evaluated whether changes in the gut microbiota of male Sprague Dawley rats, as a
result of either antibiotic or probiotic administration, influenced the oral bioavailability of two commonly
prescribed antipsychotics, olanzapine and risperidone.
Findings: The bioavailability of olanzapine, was significantly increased (1.8-fold) in rats that had undergone
antibiotic-induced depletion of gut microbiota, whereas the bioavailability of risperidone was unchanged.
There was no direct effect of microbiota depletion on the expression of major CYP450 enzymes involved in
the metabolism of either drug. However, the expression of UGT1A3 in the duodenum was significantly downregulated.
The reduction in faecal enzymatic activity, observed during and after antibiotic administration, did
not alter the ex vivo metabolism of olanzapine or risperidone. The relative abundance of Alistipes significantly
correlated with the AUC of olanzapine but not risperidone.
Interpretation: Alistipes may play a role in the observed alterations in olanzapine pharmacokinetics. The gut
microbiome might be an important variable determining the systemic bioavailability of orally administered
olanzapine. Additional research exploring the potential implication of the gut microbiota on the clinical pharmacokinetics
of olanzapine in humans is warranted.
